title: Low doses of cholestyramine in the treatment of hyperthyroidism.
abstract: The enterohepatic circulation of thyroid hormones is increased in thyrotoxicosis. Bile-salt sequestrants bind thyroid hormones in the intestine and thereby increase their fecal excretion. Based on these observations, the use of cholestyramine has been tried. The present study evaluates the effect of low doses of cholestyramine as an adjunctive therapy in the management of hyperthyroidism. In a prospective, randomized, double-blind, placebo-controlled trial, 45 patients with newly diagnosed hyperthyroid Graves' disease were randomly assigned into the following treatment protocols: group I, cholestyramine 2 g BID, methimazole and propranolol; group II, cholestyramine 1 g BID, methimazole and propranolol; group III, placebo powder, methimazole and propranolol. The fixed dose of methimazole (30 mg/d) and propranolol (40 mg/d) was used. The study period was 4 weeks. Serum total triiodothyronine and free thyroxin were measured at baseline, and at the ends of the second and the fourth week of the study. The serum thyroid hormone levels decreased more rapidly and to a greater extent in the cholestyramine-treated groups. All of the patients in group I had achieved euthyroid state at the end of the study. We conclude that low dose of cholestyramine is an effective and well-tolerated adjunctive agent in the treatment of hyperthyroid Graves' disease.
authors.affiliation: Endocrine and Metabolism Research Center, Namazi Hospital, Shiraz University of Medical Sciences, P.O. Box 71345-1414, Shiraz, Iran.
authors.forename: Mahmoud Ali
authors.initials: MA
authors.lastname: Kaykhaei
authors.forename: Mesbah
authors.initials: M
authors.lastname: Shams
authors.forename: Abdosamad
authors.initials: A
authors.lastname: Sadegholvad
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Dabbaghmanesh
authors.forename: Gholamhossein Ranjbar
authors.initials: GR
authors.lastname: Omrani
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000008:administration & dosage; D002792:Cholestyramine Resin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006111:Graves Disease / Q000150:complications / Q000188:drug therapy; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008713:Methimazole / Q000008:administration & dosage; D008875:Middle Aged; D010919:Placebos; D011433:Propranolol / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D013956:Antithyroid Agents; D010919:Placebos; D002792:Cholestyramine Resin; D008713:Methimazole; D011433:Propranolol